Tees, Esk and Wear Valleys NHS Foundation Trust

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care. Staff treated young people and their families with compassion and kindness. They respected patients’ privacy and dignity. They understood the individual needs of young people and supported them to understand and manage their care, treatment or condition. Staff involved young people and their carers in care planning and risk assessment and actively sought their feedback on the quality of care provided. Staff informed and involved families and carers appropriately. The service maintained young people’s confidentiality unless risks meant information needed to be shared with other services.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 3. The evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect. Staff attitudes and behaviours when interacting with young people evidenced that they were discreet, respectful and responsive, providing young people with help, emotional support and advice at the time they needed it.

Observation of appointments evidenced that staff supported young people to understand and manage their care, treatment or condition, engaging young people and ensuring their voice was heard throughout. One young person told us that “staff never judge you” and said they felt able to open up to the team and that there was “always a warm welcome with a smile at reception”. They also said care interventions had been designed around their particular needs and this had enabled them to use new coping skills when in distress.

We reviewed CAMHS service feedback from 2025 and 2026 and feedback around kindness and compassion of staff and services was largely positive. Comments included, “I often have regular contact with the service for my child and each time, they consistently go above and beyond to ensure my child is listened to and felt supported” and “The support we have received has been great. The people we have spoken to and seen have been really friendly, caring and kind. It's been really easy to talk to them”. Young people said staff treated them well and behaved appropriately towards them and felt staff understood them, when at times other services had not.

We spoke with 38 members of staff across the teams we visited. Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences and when they had done so, they felt validated by senior leaders. In November 2025, the Trust’s Freedom to Speak Up process changed to an external provider. The Trust had a policy in place to support staff in raising any concerns.
 

We scored the service as 3. The evidence showed a good standard. The service treated people as individuals and made sure people’s care, support and treatment met their needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. The service made adjustments for patients with a disability – for example, by ensuring the access needs of people with a disabilityto premises and by meeting patients’ specific communication needs. Teams integrated well together to provide positive behavioural support input for young people within CAMHS services. Staff were able to seek advice from other CAMHS teams in how best to progress with treatment and/or discuss best possible pathways to suit their individual needs. We observed this during morning huddles and interviews with professionals. Teams ensured that assessments were holistic to cover a wide range of current needs, consideration of historic presentations and engaged young people to codesign care plans and coping skills.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. Young people and carer feedback directly to the service was largely positive in the support that they had received. Some feedback from patient surveys stated, “staff were very friendly and approachable, made sure I fully understood what was being offered”. Carers fed back how professionals had tailored support to young people to hold appointments in the most appropriate settings, such as the team bases, home visits, school visits or while walking or having a coffee. Observations of appointments demonstrated staff were tuned in to individual needs and communication preferences. Information provided to young people and carers was appropriate to the service group. Feedback was made easy via QR codes or written feedback if more appropriate. Staff had access to written information in different languages and formats and to interpreters where needed to ensure provision of information was accessible.
 

We scored the service as 3. The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.
Staff within the services completed collaborative, individualised and focused assessments to identify the needs and risks for young people. Observations of appointments evidenced effective communication with young people to encourage engagement to ensure their voice was present throughout sessions. Staff encouraged young people and carers to consider different options of support and determine what would work best for them as an individual or family and ensure young people could remain safely within the community. Care records evidenced that staff made all attempts to engage young people and families in discussion about their care to ensure their voice was heard, however 8 records did not always make it clear if care plans had been shared with carers.

Young people and families were encouraged to provide feedback and share their views on their support and treatment both formally and informally. We spoke with young people who were involved with the Involvement Team to help further develop what young people might find helpful when engaging with services. Carer feedback indicated that they felt included and listened to during appointments that they attended. Feedback from carers referenced improvements in their child’s day to day lives and said that their child felt more in control of emotions and their needs. Feedback we reviewed had included families and young people who had previously felt failed by CAMHS services and had commented on the improved processes and treatment within this service.
 

We scored the service as 3. The evidence showed a good standard. The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. Services were clear on when situations required escalation, prioritisation or crisis team response.

Staff identified and responded to changing risks to, or posed by, patients from the information they received via triage calls, during appointments or from family members contacting the service. We observed appointments being moved forward following concerns raised by family members within teams and discussions during MDT meetings where risks of young people were discussed to formulate plans, including the wider MDT such as consultant psychiatrists, psychologists and the intensive behaviour support team.

There were clear processes for escalating risks including telephone check ins, movement of appointments to assess risks and needs, discussions with crisis teams and doctors and considerations around the use of the Mental Health Act when it was felt young people’s needs could not be safely met within the community, however, we were not always able to see these actions undertaken in patient records.

Teams we inspected were meeting targets for young people accessing support. Waiting times within neurodevelopmental assessment services remained high, however they were not disproportionately high in comparison to the national waiting times and had improved since our last inspection, despite evidence of increased referrals. We reviewed 6 months of waiting times, including those where waits for access had been longer. Reasons for delays to young people being seen included the availability of the young person to be seen, for example, if they had gone on holiday, the need for further information from referrers and increased pressures on services.There were 12 breaches reported during the 12 month period prior to inspection and most of these related to the availability of young people to attend appointments.

We scored the service as 2. The evidence showed some shortfalls. The service did not always promote the wellbeing of their staff or support and enable staff to always deliver person-centred care.

Staff were encouraged to take part in staff surveys, which were used to identify areas for improvement in services. We spoke with 38 staff across the services we inspected most staff felt well supported by leaders. 5 staff from one team felt morale in teams was low and felt that when concerns were raised about this, no changes were made and that service pressures had effect on staff well-being, however this did not affect the care given to young people. Staff were positive in their outlook of service. Staff did not always feel that there were enough opportunities to progress in their roles. There were processes in place for managers to keep in touch with staff who were on sickness leave for regular check ins and there was a clear policy for this. Staff surveys reflected the high level of stress and burnout that they experience and scored poorly for the organisation taking positive action on health and well-being.

Results of the most recent staff survey evidenced that staff felt respected by their colleagues and valued within their teams. There were mixed results in terms of reasonable adjustments within the survey with some teams scoring lower in agreeing the Trust was supportive of these. Most teams felt that there was a good culture and felt empowered to give their views. However, the staff we spoke with told us they felt respected, supported and valued within their roles. Staff were proud of the teams that they worked within and felt supported within their teams. Staff surveys showed staff felt that their immediate manager took a positive interest in health and well-being of staff.